缺血性卒中患者血清SOD,NO,MDA水平动态变化与焦虑症发生的相关性

目的 观察急性缺血性卒中(AIS)患者血清超氧化物歧化酶(SOD)、一氧化氮(NO)和丙二醛(MDA)动态变化情况,探讨氧化应激与卒中后焦虑症的关系。方法 选择2016年1月～2018年6月在宝鸡市康复医院精神科治疗的116例AIS患者作为卒中组,根据卒中发病第14天时汉密尔顿焦虑量表(HAMA)评分结果将卒中组分为焦虑组和非焦虑组,另选择80例健康体检者作为对照组。分别于入院时、卒中发病第3天、第7天和第14天检测血清SOD,NO和MDA水平。比较不同时间点各组血清SOD,NO和MDA水平,并采用ROC曲线分析评价各指标对于AIS患者发生卒中焦虑症的预测价值。结果 卒中组血清SOD水平在入院时、卒中发病第3天和第7天时较对照组均显著降低(t=3.943～19.644,均P<0.01),血清NO和MDA水平在入院时和发病第3天时较对照组均明显升高(t=8.882～18.749,均P<0.01)。焦虑组血清SOD水平在入院时和卒中发病第3天时较非焦虑组显著降低(t=5.150,5.799,均P<0.01),血清NO和MDA在卒中发病第3天时较非焦虑组明显升高(t=2.398,2.749,均P<0.05)。ROC曲线分析结果显示:卒中发病第3天血清SOD,NO和MDA预测AIS患者发生焦虑症的曲线下面积(AUC)分别为0.806,0.547和0.606,SOD的cut-off值为60.84 U/ml,对应敏感度和特异度分别为71.4%和79.7%,NO和MDA无显著性预测价值(均P>0.05)。结论 氧化应激可能参与缺血性卒中后焦虑症的发病机制。

Correlation of Dynamic Changes of Serum SOD,NO and MDA in Patients with Ischemic Stroke and Anxiety

Objective To investigate the dynamic changes ofserum level of superoxide diamutase(SOD),nitric oxide(NO)and malondiadehyde(MDA)in patients with acute ischemic stroke(AIS),and to explore the relationship of oxidative stress and anxiety after stroke.Methods 116 patients with AIS in Baoji Rehabilitation Hospital from January 2016 to June 2018 were recruited in this study as the stroke group.These patients were divided into anxiety group and non-anxiety group according to the results of Hamilton anxiety scale(HAMA)at 14th day after stroke.Meanwhile,80 healthy volunteer also were selected into this study as control.Serum SOD,NO and MDA were detected at admission,3rd day,7th day and 14th day after stroke.To compare serum level of SOD,NO and MDA among groups at several points in time.Receiver operating characteristic(ROC)curve analysis was used to determine the predictive value of serum SOD,NO and MDA in anxiety after stroke.Results Compare to control group,serum level of SOD significantly decreased at admission,3rd day,7th day after stroke(t=3.943～19.644,all P<0.01).Meanwhile,serum levels of NO and MDA significantly increased at admission and3rd day after stroke(t=8.882～18.749,all P<0.01).Serum level of SOD in anxiety group was significantly lower than that in non-anxiety group at admission and 3rd day after stroke(t=5.150,5.799,all P<0.01).However,serum levels of NO and MDA in anxiety group was significantly higher than those in non-anxiety group at 3rd day after stroke(t=2.398,2.749,all P<0.01).Basedon the ROC curve,the area under the ROC curve of serum SOD,NO and MDA at 3rd day after stroke in prediction of anxiety after stroke were 0.806,0.547 and 0.606.The boundary value of serum SOD was 60.84 U/ml.The sensitivity and specificity of serum SOD in prediction of anxiety after stroke were71.4% and 79.7%,respectively.NO and MDA had no significant predictive valuefor anxiety after stroke(both P>0.05).Conclusion Oxidative stress may play a role in pathogenesis of anxiety after stroke.